Utilization of Infertility Treatments: The Effects of Insurance Mandates

Over the last several decades, both delay of childbearing and fertility problems have become increasingly common among women in developed countries. At the same time, technological changes have made many more options available to individuals experiencing fertility problems. However, these technologies are expensive, and only 25% of health care plans in the United States cover infertility treatment. As a result of these high costs, legislation has been passed in 15 states that mandates insurance coverage of infertility treatment in private insurance plans. In this paper, we examine whether mandated insurance coverage for infertility treatment affects utilization for a specific subgroup in the population: older, highly educated women. These women are both at high risk for fertility problems, and have high rates of coverage by insurance plans affected by the mandates. We find robust evidence that while an effect of the mandates on utilization can not be found for the full population of women, the mandates do have a large and significant effect on utilization for exactly this subgroup.